PMID- 34694227
OWN - NLM
STAT- MEDLINE
DCOM- 20211028
LR  - 20211125
IS  - 1438-8871 (Electronic)
IS  - 1439-4456 (Print)
IS  - 1438-8871 (Linking)
VI  - 23
IP  - 10
DP  - 2021 Oct 25
TI  - Comparative Effectiveness of Enhanced Patient Instructions for Bowel Preparation 
      Before Colonoscopy: Network Meta-analysis of 23 Randomized Controlled Trials.
PG  - e19915
LID - 10.2196/19915 [doi]
LID - e19915
AB  - BACKGROUND: Various enhanced patient instructions (EPIs) have been used for bowel 
      preparation (BP) and our previous meta-analysis also demonstrated the efficacy of 
      EPIs in increasing the colonic polyp and adenoma detection rates; however, the 
      optimal method for adequate BP has not yet been developed. OBJECTIVE: We 
      performed a network meta-analysis to determine the optimal instructions. METHODS: 
      We searched for randomized controlled trials (RCTs) comparing the effectiveness 
      of EPIs with each other or standard patient instructions (SPIs) for BP. We 
      performed direct and Bayesian network meta-analyses for all instructions and used 
      the GRADE (Grading of Recommendations Assessment, Development and Evaluation) 
      criteria to appraise the quality of evidence. RESULTS: We included 23 RCTs (7969 
      patients) comparing 10 different instructions. In direct meta-analyses, most of 
      the EPIs, except visual aids and mobile apps, increased the adequate preparation 
      rate (APR). Network meta-analyses showed that additional explanations were 
      superior to visual aids (odds ratio [OR] 0.35, 95% CI 0.19-0.59), telephone calls 
      (OR 0.62, 95% CI 0.37-0.99), educational videos (OR 0.79, 95% CI 0.5-0.77), and 
      mobile apps (OR 0.33, 95% CI 0.14-0.68) with low-to-high-quality evidence; newly 
      designed booklets (OR 3.28, 95% CI 1.59-6.16), SMS text messaging (OR 2.33, 95% 
      CI 1.28-3.91), telephone calls (OR 1.86, 95% CI 1.03-1.78), educational videos 
      (OR 2.33, 95% CI 1.40-3.65), and social media applications (OR 2.42, 95% CI 
      1.4-3.93) were superior to visual aids and mobile apps with low-to-high-quality 
      evidence. SMS text messaging, telephone calls, and social media applications 
      increase adherence to and satisfaction with the BP regime. Social media 
      applications reduce the risk of adverse events (AEs). Telephone calls and social 
      media applications increase the polyp detection rate (PDR). CONCLUSIONS: Newly 
      designed booklets, telephone calls, educational videos, and social media 
      applications can improve the quality of BP. Telephone calls and social media 
      applications improve adherence to and satisfaction with the BP regime, reduce the 
      risk of AEs, and increase the PDR. TRIAL REGISTRATION: INPLASY (International 
      Platform of Registered Systematic Review and Meta-analysis Protocols) 
      INPLASY2020120103; https://inplasy.com/inplasy-2020-12-0103/.
CI  - (c)Xu Tian, Li-Juan Yi, Yang Han, Hui Chen, Xiao-Ling Liu, Wei-Qing Chen, Maria F 
      Jimenez-Herrera. Originally published in the Journal of Medical Internet Research 
      (https://www.jmir.org), 25.10.2021.
FAU - Tian, Xu
AU  - Tian X
AUID- ORCID: 0000-0002-3275-8751
AD  - Nursing Department, Universitat Rovira i Virgili, Tarragona, Spain.
FAU - Yi, Li-Juan
AU  - Yi LJ
AUID- ORCID: 0000-0002-3273-5816
AD  - Department of Nursing, Hunan Traditional Chinese Medical College, Zhuzhou, China.
FAU - Han, Yang
AU  - Han Y
AUID- ORCID: 0000-0002-8455-2579
AD  - Chongqing University Cancer Hospital, Chongqing, China.
FAU - Chen, Hui
AU  - Chen H
AUID- ORCID: 0000-0002-5097-7798
AD  - Chongqing University Cancer Hospital, Chongqing, China.
FAU - Liu, Xiao-Ling
AU  - Liu XL
AUID- ORCID: 0000-0002-9202-5015
AD  - Chongqing University Cancer Hospital, Chongqing, China.
FAU - Chen, Wei-Qing
AU  - Chen WQ
AUID- ORCID: 0000-0002-2910-6461
AD  - Chongqing University Cancer Hospital, Chongqing, China.
FAU - Jimenez-Herrera, Maria F
AU  - Jimenez-Herrera MF
AUID- ORCID: 0000-0003-2599-3742
AD  - Nursing Department, Universitat Rovira i Virgili, Tarragona, Spain.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20211025
PL  - Canada
TA  - J Med Internet Res
JT  - Journal of medical Internet research
JID - 100959882
SB  - IM
MH  - Colonoscopy
MH  - Humans
MH  - *Mobile Applications
MH  - Network Meta-Analysis
MH  - Randomized Controlled Trials as Topic
MH  - *Text Messaging
PMC - PMC8576559
OTO - NOTNLM
OT  - bowel preparation
OT  - colonoscopy
OT  - network meta-analysis
OT  - patient instruction
OT  - systematic review
COIS- Conflicts of Interest: None declared.
EDAT- 2021/10/26 06:00
MHDA- 2021/10/29 06:00
PMCR- 2021/10/25
CRDT- 2021/10/25 12:18
PHST- 2020/05/07 00:00 [received]
PHST- 2021/03/22 00:00 [accepted]
PHST- 2020/10/13 00:00 [revised]
PHST- 2021/10/25 12:18 [entrez]
PHST- 2021/10/26 06:00 [pubmed]
PHST- 2021/10/29 06:00 [medline]
PHST- 2021/10/25 00:00 [pmc-release]
AID - v23i10e19915 [pii]
AID - 10.2196/19915 [doi]
PST - epublish
SO  - J Med Internet Res. 2021 Oct 25;23(10):e19915. doi: 10.2196/19915.